̽��ֱ�� of Cambridge - Piers Mitchell

Early toilets reveal dysentery in Old Testament Jerusalem

fpjl2 — Fri, 26 May 2023 06:35:45 +0000

A new analysis of ancient faeces taken from two Jerusalem latrines dating back to the biblical Kingdom of Judah has uncovered traces of a single-celled microorganism Giardia duodenalis – a common cause of debilitating diarrhoea in humans.

A research team led by the ̽��ֱ�� of Cambridge say it is the oldest example we have of this diarrhoea-causing parasite infecting humans anywhere on the planet. ̽��ֱ��study is published in the journal Parasitology.

“ ̽��ֱ��fact that these parasites were present in sediment from two Iron Age Jerusalem cesspits suggests that dysentery was endemic in the Kingdom of Judah,” said study lead author Dr Piers Mitchell from Cambridge’s Department of Archaeology.

“Dysentery is a term that describes intestinal infectious diseases caused by parasites and bacteria that trigger diarrhoea, abdominal cramps, fever and dehydration. It can be fatal, particularly for young children.”

“Dysentery is spread by faeces contaminating drinking water or food, and we suspected it could have been a big problem in early cities of the ancient Near East due to over-crowding, heat and flies, and limited water available in the summer,” said Mitchell.

̽��ֱ��faecal samples came from the sediment underneath toilets found in two building complexes excavated to the south of the Old City, which date back to the 7th century BCE when Jerusalem was a capital of Judah.

During this time, Judah was a vassal state under the control of the Assyrian Empire, which at its height stretched from the Levant to the Persian Gulf, incorporating much of modern-day Iran and Iraq. Jerusalem would have been a flourishing political and religious hub estimated to have had between 8,000 and 25,000 residents.

Both toilets had carved stone seats almost identical in design: a shallow curved surface for sitting, with a large central hole for defecation and an adjacent hole at the front for male urination. “Toilets with cesspits from this time are relatively rare and were usually made only for the elite,” said Mitchell.

One was from a lavishly decorated estate at Armon ha-Natziv, surrounded by an ornamental garden. ̽��ֱ��site, excavated in 2019, probably dates from the days of King Manasseh, a client king for the Assyrians who ruled for fifty years in the mid-7th century.

̽��ֱ��site of the other toilet, known as the House of Ahiel, was a domestic building made up of seven rooms, housing an upper-class family at the time. Date of construction is hard to pin down, with some placing it around the 8th century BCE.

However, its destruction is safely dated to 586 BCE, when Babylonian ruler Nebuchadnezzar II brutally sacked Jerusalem for a second time after its citizens refused to pay their agreed tribute, bringing to an end the Kingdom of Judah.

Ancient medical texts from Mesopotamia during the first and second millennium BCE describe diarrhoea affecting the populations of what is now the Near and Middle East. One example reads: “If a person eats bread and drinks beer and subsequently his stomach is colicky, he has cramps and has a flowing of the bowels, setu has gotten him”.

̽��ֱ��cuneiform word often used in these texts to describe diarrhoea was sà si-sá. Some texts also included recommended incantations for reciting to increase the chances of recovery.

“These early written sources do not provide causes of diarrhoea, but they encourage us to apply modern techniques to investigate which pathogens might have been involved,” said Mitchell. “We know for sure that Giardia was one of those infections responsible.”

̽��ֱ��team investigated the two-and-a-half-thousand year-old decomposed biblical period faeces by applying a bio-molecular technique called 'ELISA', in which antibodies bind onto the proteins uniquely produced by particular species of single-celled organisms.

“Unlike the eggs of other intestinal parasites, the protozoa that cause dysentery are fragile and extremely hard to detect in ancient samples through microscopes without using antibodies,” said co-author and Cambridge PhD candidate Tianyi Wang.

̽��ֱ��researchers tested for Entamoeba, Giardia and Cryptosporidium: three parasitic microorganisms that are among the most common causes of diarrhoea in humans, and behind outbreaks of dysentery. Tests for Entamoeba and Cryptosporidium were negative, but those for Giardia were repeatedly positive.

Previous research has dated traces of the Entamoeba parasite, which also causes dysentery, as far back as Neolithic Greece over 4,000 years ago. Previous work has also shown that users of ancient Judean toilets were infected by other intestinal parasites including whipworm, tapeworm and pinworm.

This research was undertaken through a collaboration between the ̽��ֱ�� of Cambridge, Tel Aviv ̽��ֱ��, and the Israel Antiquities Authority.

Study of 2,500-year-old latrines from the biblical Kingdom of Judah shows the ancient faeces within contain Giardia – a parasite that can cause dysentery.

Toilets with cesspits from this time are relatively rare and were usually made only for the elite

Piers Mitchell

Ya’akov Billig

̽��ֱ��toilet seat from the estate at Armon ha-Natziv. ̽��ֱ��site, excavated in 2019, probably dates from the days of King Manasseh, a client king for the Assyrians who ruled for fifty years in the mid-7th century.

̽��ֱ��text in this work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. Images, including our videos, are Copyright © ̽��ֱ�� of Cambridge and licensors/contributors as identified. All rights reserved. We make our image and video content available in a number of ways – as here, on our main website under its Terms and conditions, and on a range of channels including social media that permit your use and sharing of our content under their respective Terms.

Yes

Medieval monks were ‘riddled with worms’, study finds

fpjl2 — Fri, 19 Aug 2022 07:20:44 +0000

A new analysis of remains from medieval Cambridge shows that local Augustinian friars were almost twice as likely as the city’s general population to be infected by intestinal parasites.

This is despite most Augustinian monasteries of the period having latrine blocks and hand-washing facilities, unlike the houses of ordinary working people.

Researchers from the ̽��ֱ�� of Cambridge’s Department of Archaeology say the difference in parasitic infection may be down to monks manuring crops in friary gardens with their own faeces, or purchasing fertiliser containing human or pig excrement.

̽��ֱ��study, published today in the International Journal of Paleopathology, is the first to compare parasite prevalence in people from the same medieval community who were living different lifestyles, and so might have differed in their infection risk.

̽��ֱ��population of medieval Cambridge consisted of residents of monasteries, friaries and nunneries of various major Christian orders, along with merchants, traders, craftsmen, labourers, farmers, and staff and students at the early university.

Cambridge archaeologists investigated samples of soil taken from around the pelvises of adult remains from the former cemetery of All Saints by the Castle parish church, as well as from the grounds where the city’s Augustinian Friary once stood.

Most of the parish church burials date from the 12-14th century, and those interred within were primarily of a lower socio-economic status, mainly agricultural workers.

̽��ֱ��Augustinian friary in Cambridge was an international study house, known as a studium generale, where clergy from across Britain and Europe would come to read manuscripts. It was founded in the 1280s and lasted until 1538 before suffering the fate of most English monasteries: closed or destroyed as part of Henry VIII’s break with the Roman Church.

̽��ֱ��researchers tested 19 monks from the friary grounds and 25 locals from All Saints cemetery, and found that 11 of the friars (58%) were infected by worms, compared with just eight of the general townspeople (32%).

They say these rates are likely the minimum, and that actual numbers of infections would have been higher, but some traces of worm eggs in the pelvic sediment would have been destroyed over time by fungi and insects.

̽��ֱ��32% prevalence of parasites among townspeople is in line with studies of medieval burials in other European countries, suggesting this is not particularly low – but rather the infection rates in the monastery were remarkably high.

“ ̽��ֱ��friars of medieval Cambridge appear to have been riddled with parasites,” said study lead author Dr Piers Mitchell from Cambridge’s Department of Archaeology. “This is the first time anyone has attempted to work out how common parasites were in people following different lifestyles in the same medieval town.”

Cambridge researcher Tianyi Wang, who did the microscopy to spot the parasite eggs, said: “Roundworm was the most common infection, but we found evidence for whipworm infection as well. These are both spread by poor sanitation.”

Standard sanitation in medieval towns relied on the cesspit toilet: holes in the ground used for faeces and household waste. In monasteries, however, running water systems were a common feature – including to rinse out the latrine – although that has yet to be confirmed at the Cambridge site, which is only partly excavated.

Not all people buried in Augustinian friaries were actually clergy, as wealthy people from the town could pay to be interred there. However, the team could tell which graves belonged to friars from the remains of their clothing.

“ ̽��ֱ��friars were buried wearing the belts they wore as standard clothing of the order, and we could see the metal buckles at excavation,” said Craig Cessford of the Cambridge Archaeological Unit.

As roundworm and whipworm are spread by poor sanitation, researchers argue that the difference in infection rates between the friars and the general population must have been due to how each group dealt with their human waste.

“One possibility is that the friars manured their vegetable gardens with human faeces, not unusual in the medieval period, and this may have led to repeated infection with the worms,” said Mitchell.

Medieval records reveal how Cambridge residents may have understood parasites such as roundworm and whipworm. John Stockton, a medical practitioner in Cambridge who died in 1361, left a manuscript to Peterhouse college that included a section on De Lumbricis (‘on worms’).

It notes that intestinal worms are generated by excess of various kinds of mucus: “Long round worms form from an excess of salt phlegm, short round worms from sour phlegm, while short and broad worms came from natural or sweet phlegm.”

̽��ֱ��text prescribes “bitter medicinal plants” such as aloe and wormwood, but recommends they are disguised with “honey or other sweet things” to help the medicine go down.

Another text – Tabula medicine – found favour with leading Cambridge doctors of the 15th century, and suggests remedies as recommended by individual Franciscan monks, such as Symon Welles, who advocated mixing a powder made from moles into a curative drink.

Overall, those buried in medieval England’s monasteries had lived longer than those in parish cemeteries, according to previous research, perhaps due to a more nourishing diet, a luxury of wealth.

Research examining traces of parasites in the remains of medieval Cambridge residents suggests that local friars were almost twice as likely as ordinary working townspeople to have intestinal worms – despite monasteries of the period having far more sanitary facilities.

One possibility is that the friars manured their vegetable gardens with human faeces

Piers Mitchell

Cambridge Archaeological Unit

Augustinian friars being excavated by the Cambridge Archaeological Unit.

̽��ֱ��text in this work is licensed under a Creative Commons Attribution 4.0 International License. Images, including our videos, are Copyright © ̽��ֱ�� of Cambridge and licensors/contributors as identified. All rights reserved. We make our image and video content available in a number of ways – as here, on our main website under its Terms and conditions, and on a range of channels including social media that permit your use and sharing of our content under their respective Terms.

Yes

Parasites from feasting at Stonehenge found in prehistoric faeces

fpjl2 — Fri, 20 May 2022 09:07:24 +0000

A study of ancient faeces uncovered at a settlement thought to have housed builders of Stonehenge suggests that parasites got consumed via badly-cooked cow offal during epic winter feasts.

Fashion for pointy shoes unleashed a plague of bunions in medieval Britain

fpjl2 — Fri, 11 Jun 2021 08:12:51 +0000

Researchers analysing skeletal remains in Cambridge find a dramatic increase in ‘hallux valgus’ around the time that pointed shoes became de rigueur in the 1300s.

Cancer rates in medieval Britain were around ten times higher than previously thought, study suggests

fpjl2 — Fri, 30 Apr 2021 08:20:03 +0000

̽��ֱ��first study to use x-rays and CT scans to detect evidence of cancer among the skeletal remains of a pre-industrial population suggests that between 9-14% of adults in medieval Britain had the disease at the time of their death.

This puts cancer prevalence in a time before exposure to tumour-inducing chemicals from industry and tobacco at around ten times higher than previously thought, according to researchers.

Prior research into historic cancer rates using the archaeological record has been limited to examining the bone exterior for lesions. It suggested that cancer was rare, affecting less than 1% of the population.

A team led by the ̽��ֱ�� of Cambridge have now coupled visual inspection with radiological imaging to analyse 143 skeletons from six medieval cemeteries in and around the city of Cambridge, UK, dating from the 6th to the 16th century.

̽��ֱ��findings of the study are published today in the journal Cancer.

“ ̽��ֱ��majority of cancers form in soft tissue organs long since degraded in medieval remains. Only some cancer spreads to bone, and of these only a few are visible on its surface, so we searched within the bone for signs of malignancy,” said lead author Dr Piers Mitchell, who conducted the research as part of the ‘After the Plague’ project.

“Modern research shows a third to a half of people with soft tissue cancers will find the tumour spreads to their bones. We combined this data with evidence of bone metastasis from our study to estimate cancer rates for medieval Britain.”

“We think the total proportion of the medieval population that probably suffered with a cancer somewhere in their body was between nine and fourteen per cent,” said Mitchell, from Cambridge ̽��ֱ��’s Department of Archaeology.

“Using CT scans we were able to see cancer lesions hidden inside a bone that looked completely normal on the outside,” said study co-author and After the Plague researcher Dr Jenna Dittmar.

“Until now it was thought that the most significant causes of ill health in medieval people were infectious diseases such as dysentery and bubonic plague, along with malnutrition and injuries due to accidents or warfare.”

“We now have to add cancer as one of the major classes of disease that afflicted medieval people,” Dittmar said.

However, the researchers point out that in modern Britain some 40-50% of people have cancer by the time they die, making the disease 3-4 times more common today than the latest study suggests it was during medieval times.

They say that a variety of factors likely contribute to contemporary rates of the disease, such as the effects of tobacco, which began to be imported into Britain in the 16th century with the colonising of the Americas.

̽��ֱ��researchers also point to the cancerous effects of pollutants that have become ubiquitous since the industrial revolution of the 18th century, as well as the possibility that DNA-damaging viruses are now more widespread with long-distance travel. Moreover, our longer lifespans give cancer much more time to develop.

̽��ֱ��skeletal remains investigated for the latest study came from sites near three villages in the vicinity of Cambridge, as well as three cemeteries uncovered within the medieval centre of the university city, including the site of a former Augustinian friary, and the site of a former charitable hospital that cared for the sick and destitute (now part of St John’s College).

Very few of the excavated remains were complete, so the team limited themselves to individuals with intact spinal column, pelvis and femora (thigh bones). Modern research shows these to be the bones most likely to contain secondary malignancies – or metastases – in people with cancer.

̽��ֱ��remains of 96 men, 46 women, and an individual of unknown sex, had their vertebrae, femurs and pelvis inspected and then imaged using x-rays and CT scans. ̽��ֱ��team found signs of malignancy in the bones of five individuals – a minimum prevalence of 3.5%. These were mostly in the pelvis, although one middle-aged man had small lesions throughout his skeleton suggesting a form of blood cancer.

Research shows that CT scans detect bone metastases around 75% of the time, and only a third to half of cancer deaths involve spread to the bone, so the team projected that 9-14% of medieval Britons developed cancer.

However, they caution that the sample size is inevitably limited and diagnosing cancer in those lain dead for many centuries is somewhat challenging.

“We need further studies using CT scanning of apparently normal skeletons in different regions and time periods to see how common cancer was in key civilizations of the past,” added Mitchell.

CT scanning used to uncover remnants of malignancy hidden inside medieval bones provides new insight into cancer prevalence in a pre-industrial world.

We searched within the bone for signs of malignancy

Piers Mitchell

Left: Jenna Dittmar. Right: Bram Mulder

Left: Excavated medieval bone from spine showing cancer metastases (white arrow). Right: CT scan of bone from a medieval skull showing metastasis hidden within (white arrow).

Yes

Ancient faeces reveal how ‘marsh diet’ left Bronze Age Fen folk infected with parasites

fpjl2 — Thu, 15 Aug 2019 23:53:31 +0000

New research published today in the journal Parasitology shows how the prehistoric inhabitants of a settlement in the freshwater marshes of eastern England were infected by intestinal worms caught from foraging for food in the lakes and waterways around their homes.

̽��ֱ��Bronze Age settlement at Must Farm, located near what is now the fenland city of Peterborough, consisted of wooden houses built on stilts above the water. Wooden causeways connected islands in the marsh, and dugout canoes were used to travel along water channels.

̽��ֱ��village burnt down in a catastrophic fire around 3,000 years ago, with artefacts from the houses preserved in mud below the waterline, including food, cloth, and jewellery. ̽��ֱ��site has been called “Britain’s Pompeii”.

Also preserved in the surrounding mud were waterlogged coprolites – pieces of human and animal faeces – that have now been collected and analysed by archaeologists at the ̽��ֱ�� of Cambridge. They used microscopy techniques to detect ancient parasite eggs within the faeces and surrounding sediment.

Very little is known about the intestinal diseases of Bronze Age Britain. ̽��ֱ��one previous study, of a farming village in Somerset, found evidence of roundworm and whipworm: parasites spread through contamination of food by human faeces.

̽��ֱ��ancient excrement of the Anglian marshes tells a different story. “We have found the earliest evidence for fish tapeworm, Echinostoma worm, and giant kidney worm in Britain,” said study lead author Dr Piers Mitchell of Cambridge’s Department of Archaeology.

“These parasites are spread by eating raw aquatic animals such as fish, amphibians and molluscs. Living over slow-moving water may have protected the inhabitants from some parasites, but put them at risk of others if they ate fish or frogs.”

Disposal of human and animal waste into the water around the settlement likely prevented direct faecal pollution of the fenlanders’ food, and so prevented infection from roundworm – the eggs of which have been found at Bronze Age sites across Europe.

However, water in the fens would have been quite stagnant, due in part to thick reed beds, leaving waste accumulating in the surrounding channels. Researchers say this likely provided fertile ground for other parasites to infect local wildlife, which – if eaten raw or poorly cooked – then spread to village residents.

“ ̽��ֱ��dumping of excrement into the freshwater channel in which the settlement was built, and consumption of aquatic organisms from the surrounding area, created an ideal nexus for infection with various species of intestinal parasite,” said study first author Marissa Ledger, also from Cambridge’s Department of Archaeology.

Fish tapeworms can reach 10m in length, and live coiled up in the intestines. Heavy infection can lead to anaemia. Giant kidney worms can reach up to a metre in length. They gradually destroy the organ as they become larger, leading to kidney failure. Echinostoma worms are much smaller, up to 1cm in length. Heavy infection can lead to inflammation of the intestinal lining.

“As writing was only introduced to Britain centuries later with the Romans, these people were unable to record what happened to them during their lives. This research enables us for the first time to clearly understand the infectious diseases experienced by prehistoric people living in the Fens,” said Ledger.

̽��ֱ��Cambridge team worked with colleagues at the ̽��ֱ�� of Bristol’s Organic Chemistry Unit to determine whether coprolites excavated from around the houses were human or animal. While some were human, others were from dogs.

“Both humans and dogs were infected by similar parasitic worms, which suggests the humans were sharing their food or leftovers with their dogs,” said Ledger.

Other parasites that infect animals were also found at the site, including pig whipworm and Capillaria worm. It is thought that they originated from the butchery and consumption of the intestines of farmed or hunted animals, but probably did not cause humans any harm.

̽��ֱ��researchers compared their latest data with previous studies on ancient parasites from both the Bronze Age and Neolithic. Must Farm tallies with the trend of fewer parasite species found at Bronze Age compared with Neolithic sites.

“Our study fits with the broader pattern of a shrinking of the parasite ecosystem through time,” said Mitchell. “Changes in diet, sanitation and human-animal relationships over millennia have affected rates of parasitic infection.” Although he points out that infections from the fish tapeworm found at Must Farm have seen a recent resurgence due to the popularity of sushi, smoked salmon and ceviche.

“We now need to study other sites in prehistoric Britain where people lived different lifestyles, to help us understand how our ancestors’ way of life affected their risk of developing infectious diseases,” added Mitchell.

̽��ֱ��Must Farm site is an exceptionally well-preserved settlement dating to 900-800 BC (the Late Bronze Age). ̽��ֱ��site was first discovered in 1999. ̽��ֱ��Cambridge Archaeological Unit carried out a major excavation between 2015 and 2016, funded by Historic England and Forterra Building Products Ltd.

Coprolites from the Must Farm archaeological excavation in East Anglia shows the prehistoric inhabitants were infected by parasitic worms that can be spread by eating raw fish, frogs and shellfish.

Consumption of aquatic organisms from the surrounding area created an ideal nexus for infection

Marissa Ledger

Left: Marissa Ledger. Right: D. Webb

Left: Microscopic egg of a fish tapeworm. Right: Must Farm excavation.

Yes

Ancient faeces reveal parasites described in earliest Greek medical texts

fpjl2 — Fri, 15 Dec 2017 04:15:11 +0000

Ancient faeces from prehistoric burials on the Greek island of Kea have provided the first archaeological evidence for the parasitic worms described 2,500 years ago in the writings of Hippocrates – the most influential works of classical medicine.

̽��ֱ�� of Cambridge researchers Evilena Anastasiou and Piers Mitchell used microscopy to study soil formed from decomposed faeces recovered from the surface of pelvic bones of skeletons buried in the Neolithic (4th millennium BC), Bronze Age (2nd millennium BC) and Roman periods (146 BC – 330 AD).

̽��ֱ��Cambridge team worked on this project with Anastasia Papathanasiou and Lynne Schepartz, who are experts in the archaeology and anthropology of ancient Greece, and were based in Athens.

They found that eggs from two species of parasitic worm (helminths) were present: whipworm (Trichuris trichiura), and roundworm (Ascaris lumbricoides). Whipworm was present from the Neolithic, and roundworm from the Bronze Age.

Hippocrates was a medical practitioner from the Greek island of Cos, who lived in the 5th and 4th centuries BC. He became famous for developing the concept of humoural theory to explain why people became ill.

This theory – in which a healthy body has a balance of four ‘humours’: black bile, yellow bile, blood and phlegm – remained the accepted explanation for disease followed by doctors in Europe until the 17th century, over 2,000 years later.

Hippocrates and his students described many diseases in their medical texts, and historians have been trying to work out which diseases they were. Until now, they had to rely on the original written descriptions of intestinal worms to estimate which parasites may have infected the ancient Greeks. ̽��ֱ��Hippocratic texts called these intestinal worms Helmins strongyle, Ascaris, and Helmins plateia.

̽��ֱ��researchers say that this new archaeological evidence identifies beyond doubt some of the species of parasites that infected people in the region. ̽��ֱ��findings are published today in the Journal of Archaeological Science: Reports.

“ ̽��ֱ��Helmins strongyle worm in the ancient Greek texts is likely to have referred to roundworm, as found at Kea. ̽��ֱ��Ascaris worm described in the ancient medical texts may well have referred to two parasites, pinworm and whipworm, with the latter being found at Kea,” said study leader Piers Mitchell, from Cambridge’s Department of Archaeology.

“Until now we only had estimates from historians as to what kinds of parasites were described in the ancient Greek medical texts. Our research confirms some aspects of what the historians thought, but also adds new information that the historians did not expect, such as that whipworm was present”.

̽��ֱ��mention of infections by these parasites in the Hippocratic Corpus includes symptoms of vomiting up worms, diarrhoea, fevers and shivers, heartburn, weakness, and swelling of the abdomen.

Descriptions of treatment for intestinal worms in the Corpus were mainly through medicines, such as the crushed root of the wild herb seseli mixed with water and honey taken as a drink.

“Finding the eggs of intestinal parasites as early as the Neolithic period in Greece is a key advance in our field,” said Evilena Anastasiou, one of the study’s authors. “This provides the earliest evidence for parasitic worms in ancient Greece.”

“This research shows how we can bring together archaeology and history to help us better understand the discoveries of key early medical practitioners and scientists,” added Mitchell.

Earliest archaeological evidence of intestinal parasitic worms infecting the ancient inhabitants of Greece confirms descriptions found in writings associated with Hippocrates, the early physician and ‘father of Western medicine’.

This research shows how we can bring together archaeology and history to help us better understand the discoveries of key early medical practitioners and scientists

Piers Mitchell

Left: Piers Mitchell/Elsevier. Right: Department of Classics, ̽��ֱ�� of Cincinnati.

Left: whipworm egg taken from ancient Greek faecal matter. Right: excavation of the Bronze Age site of Ayia Irini on the island of Kea.

̽��ֱ��text in this work is licensed under a Creative Commons Attribution 4.0 International License. For image use please see separate credits above.

Yes

Ancient faeces provides earliest evidence of infectious disease being carried on Silk Road

fpjl2 — Fri, 22 Jul 2016 09:48:48 +0000

An ancient latrine near a desert in north-western China has revealed the first archaeological evidence that travellers along the Silk Road were responsible for the spread of infectious diseases along huge distances of the route 2,000 years ago.

Cambridge researchers Hui-Yuan Yeh and Piers Mitchell used microscopy to study preserved faeces on ancient ‘personal hygiene sticks’ (used for wiping away faeces from the anus) in the latrine at what was a large Silk Road relay station on the eastern margins of the Tamrin Basin, a region that contains the Taklamakan desert. ̽��ֱ��latrine is thought to date from 111 BC (Han Dynasty) and was in use until 109 AD.

They found that eggs from four species of parasitic worm (helminths) were present: roundworm (Ascaris lumbricoides), whipworm (Trichuris trichiura), tapeworm (Taenia sp.), and Chinese liver fluke (Clonorchis sinensis).

Chinese liver fluke is a parasitic flatworm that causes abdominal pain, diarrhoea, jaundice and liver cancer. It requires well-watered, marshy areas to complete its life cycle. Xuanquanzhi relay station was located at the eastern end of the arid Tamrin Basin, an area that contains the fearsome Taklamakan Desert. ̽��ֱ��liver fluke could not have been endemic in this dry region.

In fact, based on the current prevalence of the Chinese liver fluke, its closest endemic area to the latrine’s location in Dunhuang is around 1,500km away, and the species is most common in Guandong Province – some 2,000km from Dunhuang.

Researchers from the ̽��ֱ�� of Cambridge’s Department of Archaeology and Anthropology, who conducted the study, suggest that the traveller infected with this liver fluke must have journeyed an enormous distance, and suggest the discovery provides the first reliable evidence for long distance travel with an infectious disease along the Silk Road.

̽��ֱ��findings are published today in the Journal of Archaeological Science: Reports.

“When I first saw the Chinese liver fluke egg down the microscope I knew that we had made a momentous discovery,” said Hui-Yuan Yeh, one of the study’s authors. “Our study is the first to use archaeological evidence from a site on the Silk Road to demonstrate that travellers were taking infectious diseases with them over these huge distances.”

̽��ֱ��Silk Road (or Silk Route) came to prominence during the Han Dynasty in China (202 BC – AD 220) as merchants, explorers, soldiers and government officials journeyed between East Asia and the Middle East/Mediterranean region.

Researchers have previously suggested that diseases such as bubonic plague, anthrax and leprosy might have been carried by ancient travellers along the legendary trading route, as similar strains have been found in China and Europe.

“Until now there has been no proof that the Silk Road was responsible for the spread of infectious diseases. They could instead have spread between China and Europe via India to the south, or via Mongolia and Russia to the north,” says study lead Piers Mitchell.

̽��ֱ��Cambridge team worked alongside Chinese researchers Ruilin Mao and Hui Wang from the Gansu Institute for Cultural Relics and Archaeology, who originally excavated the ancient latrine and relay station in Ganzu Province.

̽��ֱ��stop was a popular one on the Silk Road with travellers staying there and government officials using the facility to change their horses and deliver letters. While excavating the latrine, the Chinese team found the personal hygiene sticks with cloth wrapped round one end.

Added Mitchell: “Finding evidence for this species in the latrine indicates that a traveller had come here from a region of China with plenty of water, where the parasite was endemic. This proves for the first time that travellers along the Silk Road really were responsible for the spread of infectious disease along this route in the past.”

Inset: Egg of Chinese liver fluke discovered in the latrine at Xuanquanzhi, viewed using microscopy.

Intestinal parasites as well as goods were carried by travellers on iconic route, say researchers examining ancient latrine.

This proves for the first time that travellers along the Silk Road really were responsible for the spread of infectious disease along this route in the past

Piers Mitchell

Hui-Yuan Yeh

2,000-year-old personal hygiene sticks with remains of cloth, excavated from the latrine at Xuanquanzhi

̽��ֱ��text in this work is licensed under a Creative Commons Attribution 4.0 International License. For image use please see separate credits above.

Yes